Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,888.44 / $20,892.96	Facility		$3,090.30	$5,888.44	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $5,128.61 / $6,760.83	Facility		$3,019.95	$5,128.61	$6,760.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $4,570.88 / $4,897.79	Facility		$3,981.07	$4,570.88	$4,897.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility		$3,311.31	$3,311.31	$3,311.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,311.31 / $37,153.52	Facility		$1,122.02	$3,311.31	$37,153.52